What Are the Symptoms and Signs of Syphilis?

Syphilis is a bacterial infection that spreads through sexual contact.
Syphilis is a bacterial infection that spreads through sexual contact.

Syphilis is a bacterial infection that spreads through sexual contact. It is caused by the spirochete bacterium, Treponema pallidum. The first sign of syphilis is most commonly a painless sore, called a chancre, which develops where the bacteria enters the body. The chancre typically appears within 3 weeks from the time of exposure. It is usually in the area of the genitals, rectum, or mouth, and it can go unnoticed if it is hidden inside the body. The other signs and symptoms of syphilis based on the different stages include:

Primary stage:

  • The patient may present with a painless sore (called a ‘chancre’) at the site of infection after 10 days to 3 months of the infection. This usually appears on the penis, vagina, in the mouth, or around the rectum. Some people get several sores.
  • Glands in the neck, groin, or armpits may swell.
  • The sores are very infectious. They heal after about 2 to 8 weeks and disappear.
  • Even after the sore goes away, treatment is necessary to stop the infection from progressing to the secondary stage.

Secondary stage:

  • Usually begins with a rash on one or more areas of the body. The rash can appear as rough, red, or reddish-brown spots, but sometimes it is very faint and not noticeable.
  • Sores in the mouth, vagina, or anus. Growths like genital warts appearing near the anus in men and women as well as near the vulva in women.
  • White patches in the mouth
  • Fever
  • Swollen lymph glands
  • Sore throat
  • Patchy hair loss
  • Headaches
  • Weight loss
  • Muscle aches
  • Fatigue
  • Patchy hair loss
  • Without proper treatment, the infection will progress to the latent and possibly to tertiary stages.

Latent stage:

It is the third stage of infection marked by the relative absence of symptoms but positive blood tests. It is further divided into two stages:

  • Early latent syphilis is the period of less than a year from the last blood test. Secondary symptoms can sometimes relapse during the early latent phase.
  • Late latent syphilis is the period greater than a year from the last blood test. It can last for years and even decades with no signs of disease.

Tertiary syphilis:

Tertiary syphilis is the most serious stage of infection and is characterized by three major complications: 

  • Gummatous syphilis: It causes the formation of soft, tumor-like lesions called gummas. These non-cancerous lesions can cause large ulcerative sores on the skin and mouth and erode tissues of the heart, liver, muscles, bones, and other vital organs. Symptoms typically develop between three and 10 years after being infected.
  • Cardiovascular syphilis: It may cause severe swelling of the aorta and the development of an aortic aneurysm (the swelling and weakening of the aortic wall). It generally occurs 10 to 30 years after the initial infection.
  • Neurosyphilis: It affects the central nervous system and usually develops within 4 to 25 years of infection. While some people will remain symptom-free, others may experience severe neurological symptoms, including meningitis (swelling of the membrane surrounding the brain and spinal cord) or other conditions characterized by nerve pain, loss of motor skills, visual impairment, deafness, and incontinence. Seizures, personality changes, hallucinationsdementia, schizophrenia, and stroke may also occur in this stage.
  • Although the syphilis infection can be treated during the tertiary stage, any damage caused to the heart, kidneys, and other organs may be permanent and lead to end-stage organ failure. Treatment is determined by the type and extent of the damage. Syphilis is not contagious during the tertiary stage.

How syphilis is usually treated?

The treatments of syphilis include:

  • Penicillin injection is considered as the treatment of choice for all stages of syphilis.
  • A stat dose of benzathine or procaine penicillin may be required for infectious syphilis (primary, secondary, early latent).
  • Large doses of benzathine or procaine penicillin are required for noninfectious syphilis (late latent) and neurosyphilis.
  • Sometimes tetracyclines or cephalosporins can be used in patients who are allergic to penicillin.
  • A pregnant woman who is allergic to penicillin should first be desensitized and then treated with penicillin anyway.

Can we prevent syphilis?

There is no vaccine for syphilis. Practicing hygiene and following a few tips may be helpful.

  • Having only one sexual partner (and ensuring that the person is monogamous too)
  • Using condoms during sexual activity
  • Avoiding alcohol and recreational drugs
  • Screening all pregnant women for syphilis and, if detected it be treated with penicillin to prevent congenital syphilis.

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Medically Reviewed on 9/16/2020
References
Syphilis - CDC Fact Sheet: (https://jacksoncountyor.org/hhs/Public-Health/CDC/STD-Awareness-Info/Syphilis-Facts)

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